Symptoms of interstitial cystitis, painful bladder syndrome and similar diseases in women: a systematic review

Bogart LM, Laura M Bogart, Berry SH, Sandra H. Berry, Clemens JQ, J. Quentin Clemens
Journal of Urology · 2007 · doi:10.1016/j.juro.2006.09.032 · PMID:17222607
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This systematic review identifies bladder pain, urgency, and frequency as key interstitial cystitis symptoms, noting that dysmenorrhea distinguishes endometriosis from interstitial cystitis despite frequent comorbidity.

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This systematic review evaluated clinical literature to determine how best to distinguish interstitial cystitis from related pelvic pain conditions in women. The authors analyzed 604 articles and found that interstitial cystitis and painful bladder syndrome share identical symptom clusters, while recurrent urinary tract infections can be differentiated through self-reporting and urine cultures. Key distinguishing features identified included dysmenorrhea for endometriosis, vulvar pain for vulvodynia, and the presence of pain to separate these from overactive bladder. Relevance to endometriosis: listed as one condition whose symptoms (specifically dysmenorrhea) help differentiate it from interstitial cystitis, though the paper notes many women suffer from both simultaneously.

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Abstract

PURPOSE: In women symptoms of interstitial cystitis are difficult to distinguish from those of painful bladder syndrome and they appear to overlap with those of urinary tract infection, chronic urethral syndrome, overactive bladder, vulvodynia and endometriosis. This has led to difficulties in formulating a case definition for interstitial cystitis, and complications in the treatment and evaluation of its impact on the lives of women. We performed a systematic literature review to determine how best to distinguish interstitial cystitis from related conditions. MATERIALS AND METHODS: We performed comprehensive literature searches using the terms diagnosis, and each of interstitial cystitis, painful bladder syndrome, urinary tract infection, overactive bladder, chronic urethral syndrome, vulvodynia and endometriosis. RESULTS: Of 2,680 screened titles 604 articles were read in full. The most commonly reported interstitial cystitis symptoms were bladder/pelvic pain, urgency, frequency and nocturia. Interstitial cystitis and painful bladder syndrome share the same cluster of symptoms. Chronic urethral syndrome is an outdated term. Self-reports regarding symptoms and effective antibiotic use can distinguish recurrent urinary tract infections from interstitial cystitis in some but not all women. Urine cultures may also be necessary. Pain distinguishes interstitial cystitis from overactive bladder and vulvar pain may distinguish vulvodynia from interstitial cystitis. Dysmenorrhea distinguishes endometriosis from interstitial cystitis, although many women have endometriosis plus interstitial cystitis. CONCLUSIONS: In terms of symptoms interstitial cystitis and painful bladder syndrome may be the same entity. Recurrent urinary tract infections may be distinguished from interstitial cystitis and painful bladder syndrome via a combination of self-report and urine culture information. Interstitial cystitis and painful bladder syndrome may be distinguished from overactive bladder, vulvodynia and endometriosis, although identifying interstitial cystitis and painful bladder syndrome in women with more than 1 of these diseases may be difficult.
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Materials and methods

We performed comprehensive literature searches using the terms diagnosis, and each of interstitial cystitis, painful bladder syndrome, urinary tract infection, overactive bladder, chronic urethral syndrome, vulvodynia and endometriosis.

Results

Of 2,680 screened titles 604 articles were read in full. The most commonly reported interstitial cystitis symptoms were bladder/pelvic pain, urgency, frequency and nocturia. Interstitial cystitis and painful bladder syndrome share the same cluster of symptoms. Chronic urethral syndrome is an outdated term. Self-reports regarding symptoms and effective antibiotic use can distinguish recurrent urinary tract infections from interstitial cystitis in some but not all women. Urine cultures may also be necessary. Pain distinguishes interstitial cystitis from overactive bladder and vulvar pain may distinguish vulvodynia from interstitial cystitis. Dysmenorrhea distinguishes endometriosis from interstitial cystitis, although many women have endometriosis plus interstitial cystitis.

Conclusions

In terms of symptoms interstitial cystitis and painful bladder syndrome may be the same entity. Recurrent urinary tract infections may be distinguished from interstitial cystitis and painful bladder syndrome via a combination of self-report and urine culture information. Interstitial cystitis and painful bladder syndrome may be distinguished from overactive bladder, vulvodynia and endometriosis, although identifying interstitial cystitis and painful bladder syndrome in women with more than 1 of these diseases may be difficult.

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Condition tags

endometriosisdysmenorrheainterstitial_cystitis

MeSH descriptors

Cystitis, Interstitial Cystitis, Interstitial Diagnosis, Differential Female Humans Urinary Bladder Diseases Urinary Bladder Diseases

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